CHICAGO
-- A survey of doctors who wrote treatment guidelines for common
diseases such as diabetes, depression and arthritis found that
most had ties to drug companies, but few thought those ties influenced
their recommendations.

The findings, published in Wednesday's Journal of the American
Medical Association, suggest drug company connections could have
compromised the doctors' ability to create objective guidelines
that served patients' best interests.

Among those who responded to the survey, 58 percent said they
had received research funding from drug companies and 38 percent
said they had served as company employees or consultants.

Moreover, 59 percent of the doctors said they had ties to pharmaceutical
companies whose drugs were considered in the drafting of the guidelines
they wrote.

Of these authors, 96 percent said the relationships were formed
before the guidelines were created. Only 7 percent thought the
ties affected their own guideline recommendations, although 19
percent thought such ties influenced their co-authors' recommendations.

"Unfortunately, bias may occur both consciously and subconsciously,
and therefore its influence may go unrecognized," lead author
Dr. Niteesh Choudhry and his colleagues at the University of Toronto
said in the study.

The results were based on a survey mailed to 192 doctors involved
with creating 44 "clinical practice guidelines" for treating diseases.
Only 100 doctors provided usable responses, and whether they accurately
assessed drug companies' influence over them is not known, the
survey authors said.

The survey was mailed to authors of guidelines endorsed by North
American and European medical societies and published between
1991 and 1999.